Human immunodeficiency virus case detection and antiretroviral therapy enrollment among children below and above 18 months old: A comparative analysis from Cameroon.
Human immunodeficiency virus case detection and antiretroviral therapy enrollment among children below and above 18 months old: A comparative analysis from Cameroon.
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DOI：
10.1097/md.0000000000025510
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发表时间：
2021-04-30
期刊：
影响因子：
1.6
通讯作者：
Kuaban C
中科院分区：
文献类型：
--
作者：
Yumo HA;Ndenkeh JN Jr;Sieleunou I;Nsame DN;Kuwoh PB;Beissner M;Loscher T;Kuaban C
虽然儿科人类免疫缺陷病毒（艾滋病毒）检测更侧重于18个月以下的儿童，通过预防母婴传播艾滋病毒（PMTCT），这种方法的收益仍然不清楚相比，通过常规提供者发起的测试和咨询（PITC）测试18个月以上的儿童。 这项研究旨在评估和比较喀麦隆18个月以下和18个月以上儿童的艾滋病毒病例检测和抗逆转录病毒治疗登记情况。 需要这些信息来指导对儿童和青少年艾滋病毒检测的投资。我们进行了一项横断面研究，邀请父母在3家医院访问或接受艾滋病毒护理，让他们的孩子接受艾滋病毒检测。分别对18个月以下和18个月以上的儿童进行聚合酶链反应（PCR）和抗体快速检测。 我们使用卡方检验在5%的显着水平上比较了2个儿童亚组之间的艾滋病毒病例检测和ART启动情况。共有4079名6周至15岁的儿童被纳入分析。 与<18个月的儿童相比，参加研究的儿童中≥18个月的儿童组高出4倍（80.3% vs 19.7%，P <.001）;检测HIV的人高出3.5倍（77.6% vs 22.4%，P <.001）;检测HIV+的人高出6倍（85.7% vs 14.3%，P =.24），参加ART的人高出11倍（91.7% vs 8.3%，P =.02）。 我们的研究结果显示，5名接受艾滋病毒检测的儿童中有4名是18个月以上的儿童，90%以上的ART登记病例是18个月以上的儿童。 因此，在为新生儿和婴儿推出聚合酶链反应艾滋病毒检测技术的同时，为年龄较大的儿童提供充足和相称的抗体快速检测资源，并不是实现无艾滋病一代的先决条件。
While pediatric human immunodeficiency virus (HIV) testing has been more focused on children below 18 months through prevention of mother to child transmission of HIV (PMTCT), the yield of this approach remains unclear comparatively to testing children above 18 months through routine provider-initiated testing and counselling (PITC). This study aimed at assessing and comparing the HIV case detection and antiretroviral therapy (ART) enrolment among children below and above 18 months of age in Cameroon. This information is required to guide the investments in HIV testing among children and adolescents. We conducted a cross-sectional study where we invited parents visiting or receiving HIV care in 3 hospitals to have their children tested for HIV. HIV testing was done using polymerase chain reaction (PCR) and antibody rapid tests for children <18 months and those ≥18 months, respectively. We compared HIV case detection and ART initiation between the 2 subgroups of children and this using Chi-square test at 5% significant level. A total of 4079 children aged 6 weeks to 15 years were included in the analysis. Compared with children <18 months, children group ≥18 months was 4-fold higher among those who enrolled in the study (80.3% vs 19.7%, P < .001); 3.5-fold higher among those who tested for HIV (77.6% vs 22.4%, P < .001); 6-fold higher among those who tested HIV+ (85.7% vs 14.3%, P = .24), and 11-fold higher among those who enrolled on ART (91.7% vs 8.3%, P = .02). Our results show that 4 out of 5 children who tested HIV+ and over 90% of ART enrolled cases were children ≥18 months. Thus, while rolling out PCR HIV testing technology for neonates and infants, committing adequate and proportionate resources in antibody rapid testing for older children is a sine quo none condition to achieve an acquired immunodeficiency syndrome (AIDS)-free generation.